Saturday, 1 December 2012

6 Ways to Advocate for Your Mental Health

Often there are many parts of the mental health treatment process that you can’t control. “Providers can let patients down, medications may fail or cause uncomfortable side effects [and] there is enormous stigma around mental illness,” said Kelli Hyland, M.D., a psychiatrist in outpatient private practice in Salt Lake City, Utah.But you can control your role. For instance, you can accept your symptoms, educate yourself about your illness, build your treatment team and speak “up when you feel small and scared,” she said.Advocating for your mental health provides significant benefits. “Taking an active role in the healing process brings empowerment, confidence and can build quality of life independent of cure or physical wellness,” she said.Below, Hyland shared several ways you can become your own best advocate.1. Work with reputable experts. Whether you’re looking for a therapist, an entire treatment team or a mental health facility, picking the right practitioner or place takes time and effort, Dr. Hyland said. (But, as she underscored, it’s your health.)The key is to ask around, do your research, and “interview the providers like you are hiring an employee.” Look for knowledge and expertise, along with fit and rapport, she said.You might interview several providers before picking the right one. And you might work with someone for several sessions and realize they’re not a good fit. (If that’s the case, keep your records, she said.)As Hyland said, “Remember you are paying for a service. You do not have to hire someone that you do not like or doesn’t meet your current needs.”Hyland often helps friends, family members and anyone who calls her find trusted practitioners she’d see herself — whether it’s a primary care physician, therapist, psychiatrist, substance abuse treatment or other specialist.If you’re already seeing a therapist, ask them to refer you to several providers, she said. For instance, like Hyland, your therapist might be able to recommend a psychiatrist or treatment center.If your city has a reputable training program, call their department, she said. Or “better yet, ask a trainee who they like working with, would send a family member to or see themselves.” As Hyland added, “they usually work the closest with providers or know the ‘inside scoop’ and aren’t going to give you a political answer.”Another option is to call your state’s American Psychological Association or American Psychiatric Association, she said. “The executive assistant of the Utah Psychiatric Association has sent some great referrals my way and knows who all the docs are and keeps notes on who does what well.”2. Be the best expert on you. While you might not know much about medication or the mental health field, you do know a whole lot about yourself. “You are the most experienced person about you,” Hyland said. She identified several ways you can use your expertise: “Keep a sleep or mood journal, understand and share your narrative, process your emotions, write your story, ask yourself difficult and scary questions, ask for feedback from people you love and trust, follow your intuition.” 3. Face one issue at a time.Dealing with a mental illness is challenging. (And some days this might seem like an understatement.) You have to traverse a confusing mental health system, stigma and judgment from others – even clinicians – along with intrusive symptoms, such as negative thoughts, intense anxiety and feelings of worthlessness, Hyland said.This can seem incredibly overwhelming. That’s why it’s important to remind yourself to focus on one step at a time, she said. “Take breaks from the ‘fight’ and find and focus on even just one little thing that brings you any pleasure or brings you into this one moment.”4. Lower your expectations. Lower your expectations when it comes to yourself — such as the time and energy you dedicate to your health and wellness – and your treatment — such as your doctor or treatment plan, she said. Many of Hyland’s clients tend to “overdo it,” she said. She works with them to “focus less on outcome and more on small successes or quality of life issues versus cure.”5. Seek out reputable resources. “Avoid anything on the Internet that appears to be entertainment, voyeuristic, extremist or conspiracy-based,” Hyland said. Instead, visit trusted websites such as NAMI, which includes valuable patient education handouts and information on advocacy, she said.For advocacy and education she also recommended William Marchand’s Depression and Bipolar Disorder: Your Guide to Recovery along with narratives such as Kay Jamison’s An Unquiet Mind.Hyland recommends Susan Cain’s Quiet to her introverted clients, who also struggle with avoidance or anxiety problems.“These are examples of smart books but also very personal stories, which can help patients feel less alone and ‘crazy,’” she said.She also suggested Alcoholics Anonymous (AA), Narcotics Anonymous (NA) and Al-Anon. “I often refer patients to Al-Anon, even if they are not in relationship with someone with addiction, but simply if they are struggling with enmeshment or over-caregiving in any context,” she said. AA’s Big Bookor Big Blue Book is particularly “great for healthy coping skills and support,” she said.6. Be kind to yourself.“Please be kind to yourself about this hand you have been dealt,” Hyland said. She cited this quote from Caroline Kettlewell, which she keeps in her office:

If a heart could fail in its pumping, a lung in its breathing, then why not a brain in its thinking, rendering the world forever askew, like a television with bad reception? And couldn’t a brain fail as arbitrarily as any of these other parts, without regard to how fortunate your life might have been?

In addition, celebrate your accomplishments, and “surround yourself with people who are good at self-care and other-care,” Hyland said. Always speak up, and voice any questions or concerns to your providers. “Consider your healthcare treatment plan as dynamic, in flux, growing; a constant ongoing dialogue, a work in progress,” she said.